Conduct MS DRG and APR DRG coding reviews to verify the accuracy of DRG assignment and reimbursement with a focus on overpayment identification Expert knowledge of and the ability to identify the ICD 10 CM/PCS code assignment, appropriate code sequencing, present on admission (POA) assignment, and discharge disposition, in accordance with CMS requirements, ICD 10 Official

Pricing support for OptumInsight Payer software and services product suite Pull and manipulate operational and financial data Maintain and enhance pricing models and templates Effectively work with cross functional teams that include Finance, Sales, Product and Operations Develop a strong understanding of the business mission through effective interactions with upper mana

Oversee detailed data analytics and financial projections (e.g., MicroStrategy, Excel) and translate findings to operational stakeholders Perform project / program management activities, such as monitoring client scope, creating and tracking deliverables, creating status reports, identifying and mitigating risks, managing resource plans, and monitoring successful achievem

IT Pillar financial responsibilities spanning across multiple long term MPP clients totaling billions of dollars in TCV Scaling financial operations related to IT Delivery across MPP clients Monitoring of financial spend in comparison to contract to ensure that no financial leakage occurs Work with operational leaders to monitor financial performance compared to deal pro

Help process provider credentialing and enrollment applications and re applications including initial mailing, review and loading into the database tracking system Conduct audits and provide feedback to reduce errors and improve processes and performance Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others Solve complex pro

Identify appropriate assignment of ICD 10 CM and ICD 10 PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC/MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Identify appropriate assignment of CPT and ICD 10 Codes for outpatient sur

Perform financial clearance processes by interviewing patients and collecting and recording all necessary information for pre registration of patients Educate patients of pertinent policies as necessary i.e., Patient Rights, HIPAA information, consents for treatment, visiting hours, etc Verify insurance eligibility and completes automated insurance eligibility verificatio

Responsible for greeting and welcoming patients in person. Provides a standard registration process by collecting demographic and financial data and enter information into a electronic medical record. Primary Responsibilities Greets and welcomes patient in person Collects demographic and insurance information Checks in or interviews patient to complete appropriate paperwo

Meet with clients that lack funding for SNF stay; assist with/facilitate application to Medical Assistance, application for Long Term Care and/or application to State Medical Review Team (SMRT) including securing forms, documentation and verifications required Submission and tracking of Medicaid applications Contact county and state offices regarding application status; p

Resolves highly complex business problems that affect clinical processes and functional requirements Participates in the development of measurable clinical business, affordability, and quality goals Identifies and prepares recommendations for cross functional/cross CDO medical management process improvements and opportunities Leverages data from multiple sources and analy

Lead the enterprise MarTech strategy & architecture Lead a global team of 600+ (FTE & vendor partner) focused on enterprise marketing and select Optum Rx line of business capabilities including quality, contact center and outbound communications technologies Manage capital investments of $75M+ & delivering on $975M+ of enterprise benefits in the next 5 years Execute on th

Responsible for greeting and welcoming patients in person. Provides a standard registration process by collecting demographic and financial data and enter information into a electronic medical record. Primary Responsibilities Greets and welcomes patient in person Collects demographic and insurance information Checks in or interviews patient to complete appropriate paperwo

Responsible for completing the financial clearance process and creating the first impression of Optum services to patients, their families, and other external customers. You will articulate information in a manner that patients, guarantors, and family members understand and will know what to expect regarding their financial responsibilities. Work with medical staff, nursi

Coordinates the resolution of unpaid accounts. Receives and resolves calls from patients, insurance companies, attorneys, and departments. Obtains and processes payments. Collaborates with patients to create payment arrangements. Updates incomplete and missing account information. Documents collection activities. Other duties as assigned. You'll be rewarded and recognized

Responsible for completing the financial clearance process and creating the first impression of Optum services to patients, their families, and other external customers. You will articulate information in a manner that patients, guarantors, and family members understand and will know what to expect regarding their financial responsibilities. Work with medical staff, nursi